title: Anthroposophic supportive treatment in children with medulloblastoma receiving first-line therapy.
abstract: BACKGROUND
  The use of anthroposophic medicine (AM) is popular in Central Europe, especially in German-speaking countries. Although these therapies are judged to be beneficial by many patients, there are few data with regard to the safety and efficacy in pediatric oncology. Several theoretical concerns have been published with regard to tumor enhancement or promotion of metastatic dissemination due to mistletoe. To test the indirect safety of supportive anthroposophic treatment accompanying the first-line treatment in children with medulloblastoma in this respect we performed a retrospective matched-pair analysis of patients with medulloblastoma treated by standard first-line radiochemotherapy with or without a concomitantly applied panel of AM including mistletoe. The question was whether the effectiveness of the first-line therapy is altered by AM.
  
  
  METHODS
  Seventeen patients with AM were matched in a 1:2 ratio with 34 patients from the database of the German HIT study group with regard to the criteria of diagnosis, age, status of metastatic dissemination, resection status, and first-line therapy.
  
  
  RESULTS
  The overall survival after 10 years was 58.33% for the AM group and 57.14% for the control group, that is, showing no statistically significant difference (stratified Cox regression; P=0.6023). Event-free survival (including metastases) also did not differ between the groups (stratified Cox regression; P=0.4275).
  
  
  CONCLUSIONS
  AM consisting of different combinations of specific pharmacologic and nonpharmacologic interventions seems to be safe with respect to any potential negative impact on the first-line therapy. There is no evidence with regard to tumor enhancement. The effectiveness of the supportive AM cannot be assessed on the basis of these data.
authors.affiliation: Department of Pediatric Oncology and Hematology, Otto-Heubner-Center for Pediatric and Adolescent Medicine (OHC), Charité, Universitätsmedizin Berlin, Berlin. georg.seifert@charite.de
authors.forename: Georg
authors.initials: G
authors.lastname: Seifert
authors.forename: Stefan
authors.initials: S
authors.lastname: Rutkowski
authors.forename: Patrick
authors.initials: P
authors.lastname: Jesse
authors.forename: Rene
authors.initials: R
authors.lastname: Madeleyn
authors.forename: Marcus
authors.initials: M
authors.lastname: Reif
authors.forename: Günter
authors.initials: G
authors.lastname: Henze
authors.forename: Alfred
authors.initials: A
authors.lastname: Längler
mesh_terms: D000293:Adolescent; D000887:Anthroposophy; D002528:Cerebellar Neoplasms / Q000401:mortality / Q000628:therapy*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008527:Medulloblastoma / Q000401:mortality / Q000628:therapy*; D016016:Proportional Hazards Models; D012189:Retrospective Studies